Abstract
Introduction:Distraction osteogenesis has been used effectively in the management of tibia non-unions with skeletal defect. A retrospective case series study of the infected non-union tibia managed with acute docking in a rail fixation system was conducted at a tertiary care hospital in South India. It was designed to evaluate the use of autologous bone graft at the docking site in achieving an early union with a seven years follow-up period.Materials and Methods:From 2010 to 2017, a total of 19 patients with infected tibia non-union and a bone defect less than 3cm, were treated with debridement and a monolateral frame fixation with acute shortening and lengthening. The patients were divided into two groups: one in which no bone graft was used at the docking site during early years of the study; and a later group in which autologous bone graft was used at the acute docking site primarily in addition to compression. Consolidation at the docking site was assessed both radiographically and clinically, and the results were statistically analysed.Results:There were 12 patients in Group I without bone graft, where consolidation at the docking site was noted after a mean duration of 22.08 ± 3.87 weeks. There were seven patients in Group II with bone graft, where the mean time for docking site consolidation was significantly lower at 16.57 ± 3.82 weeks. No docking site complications were noted in either group.Conclusion:Primary autologous bone graft enhances docking site consolidation in acute shortening. The routine use of bone graft at the docking site in acute shortening will expedite the docking site union with reduction of treatment time.
Highlights
Distraction osteogenesis has been used effectively in the management of tibia non-unions with skeletal defect
Defects of the tibia measuring less than 3cms are treated with acute docking and lengthening wherein the bone defect is acutely closed and length achieved by distraction at the corticotomy site[1,2,3,4]
From June 2010 to July 2017 a total of 19 patients with infected tibia non-union who were treated with debridement and monolateral frame fixation were enrolled into the study
Summary
Distraction osteogenesis has been used effectively in the management of tibia non-unions with skeletal defect. It was designed to evaluate the use of autologous bone graft at the docking site in achieving an early union with a seven years follow-up period. Results: There were 12 patients in Group I without bone graft, where consolidation at the docking site was noted after a mean duration of 22.08 ± 3.87 weeks. There were seven patients in Group II with bone graft, where the mean time for docking site consolidation was significantly lower at 16.57 ± 3.82 weeks. Defects of the tibia measuring less than 3cms are treated with acute docking and lengthening wherein the bone defect is acutely closed and length achieved by distraction at the corticotomy site[1,2,3,4]
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